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Quincke's edema (Quincke's disease)
Quincke's edema — mainly allergic reaction of an organism to action of various factors of chemical and biological character. For the first time this state was described in 1882 by the German doctor Heinrich Quincke on behalf of whom there is a name of this disease. It is also accepted to call a Quincke's edema a Quincke's disease, the huge small tortoiseshell.
In development of this acute allergic disease the person has a massive cutaneous dropsy, a mucous membrane and a hypodermic fatty tissue. Most often the Quincke's edema is shown on a neck, and on an upper half of a trunk. Display of hypostasis on the back of feet and brushes is also possible. Situations when the Quincke's edema affects joints, brain covers, other bodies are considered as more rare.
The Quincke's edema can arise at each person, but nevertheless the highest risk of development of this state exists at patients at whom various allergies are observed. Most often this disease arises at children and young women, less often elderly people have it.
Quincke's edema reasons
There are two types of a Quincke's edema: hypostasis allergic and hypostasis pseudo-allergic. At edematization of Quincke of the reason of this state in each case different. At the first type of a disease manifestation of a Quincke's edema which symptoms are observed at people, inclined to an allergy, arises as a result of especially strong allergic reaction of a human body. Such reaction is a peculiar response to emergence in an organism of offending allergen. Very often such state can be combined with an allergy to food stuffs, urticaria, bronchial asthma, pollinoses.
People at whom inborn pathology of system of a complement is observed often suffer from a pseudo-allergic Quincke's edema. System of a compliment it is accepted to call group of blood proteins which take part in development of allergic and priming immune responses. These proteins constantly stay in an inactive state: their activation happens only during hit of alien antigen in an organism. At emergence of a pseudo-allergic Quincke's edema the system of a compliment is activated or is spontaneous, or as reaction to thermal, cold, chemical irritations. As a result the person has a strong allergic reaction.
The Quincke's edema at children of younger age is shown rather seldom. However even the baby can have this dangerous state. Most often the Quincke's disease is shown at girls and women.
Quincke's edema symptoms
At the patient with a Quincke's edema symptoms, first of all, are shown by developing of acute hypostasis of facial tissues, necks, feet and palms on their back. Skin in the place of hypostasis considerably turns pale. As a rule, at a Quincke's edema the itch does not arise. At different situations the shown Quincke's edema disappears several hours later or days.
For the person the biggest danger is constituted by hypostasis of a throat, throat, trachea. According to medical statistics, such manifestations take place at every fourth patient with a Quincke's disease. At similar development of a disease of the patient begins to feel sharp concern, it becomes difficult for it to breathe, he can faint. At survey of a mucous membrane of a throat hypostasis of a soft palate and palatal handles is found, the pharynx gleam at the same time is narrowed. If hypostasis extends to a trachea and a throat, the death of the person from asthma is possible.
The Quincke's disease at children arises as limited cutaneous dropsies, and also mucous membranes. At emergence of a Quincke's edema on internals of the child severe pains in a stomach, vomiting and a diarrhea can disturb.
Diagnosis of a Quincke's edema
The diagnosis in this case is established after the doctor got acquainted with the available disease symptoms. Also reaction of hypostasis to administration of adrenaline is considered. In the course of diagnosis it is very important to define what became an origin at a sick Quincke's edema. Therefore the doctor has to conduct surely detailed survey about existence of allergic diseases at the patient, and also at his family members. It is important to define its reaction to drugs, influence on a condition of the person of physical factors, contact with animals, foodstuff, etc.
In the course of diagnosis the doctor can appoint carrying out a laboratory blood analysis. Sometimes in need of process of diagnosis of a Quincke's disease it is necessary to carry out skin allergological tests.
Treatment of a Quincke's edema
To the patient at whom the Quincke's edema developed treatment is carried out with the purpose to suppress allergic reaction. In each separate case of display of this disease it is necessary to consider surely a possibility of edematization in respiratory tracts and the subsequent death of the person owing to asthma. Therefore at development in sick damage of a throat and throat it is necessary to call the ambulance as soon as possible. The patient with a Quincke's disease of a throat or throat is hospitalized and further treatment is carried out to reanimations or an intensive care unit.
If the feeding response takes place, the attending physician will surely recommend strict following to a hypoallergenic diet. In the course of treatment of a Quincke's disease both at children, and at adults purpose of reception of antihistamines is possible. If sensitivity to food stuffs takes place, reception of fermental drugs, for example, of festal can reduce it.
Quincke's edema at children
The Quincke's edema at children can sometimes develop to very big sizes. At the same time there is its migration, that is hypostasis is shown in one, in other place. Swelled to the touch very dense and homogeneous when to press it, deepening does not appear. Approximately in half of cases there is a combination of a Quincke's edema and the small tortoiseshell. However the most serious state is throat hypostasis. In this case parents have to pay attention to the following characteristic manifestations: initial it becomes very difficult for child to breathe, face skin gains blue color, a little later she sharply turns pale. Duration of hypostasis of a throat easy and moderate severity sometimes makes from one hour to one days.
At emergence of a Quincke's edema in a digestive tract initially the child complains of feeling of a pricking of the sky, language then there is a diarrhea and vomiting. Also the child is disturbed by a sharp abdominal pain.
Even at manifestation of a Quincke's edema only on skin the child sometimes suffers from fever, pain in joints, strong excitement. The loss of consciousness is also possible.
Emergence of a Quincke's edema perhaps and as a result of reception of some medicines. First of all, swelled to provoke reception of antibiotics, in particular penicillin. Also the drugs removing spasms, vitamins of group B, acetylsalicylic acid, iodine drugs are unsafe for children, inclined to an allergy. Substances which are additives of some medicines can cause also similar reaction.
Parents have to consider and the fact that can provoke edematization of Quincke at the child not only certain food stuffs, to which at the kid an allergy, but also additives which are contained in some foodstuff. It is a number of preservatives and dyes which often are in sausages, sausages, juice, cheese, etc. Exotic dishes, for example, from fish, also conceal in themselves danger of provoking of a Quincke's edema.
Besides, for children inclined to an allergy, blossoming of plants, and also stings of insects is unsafe.
First aid at a Quincke's edema
If the child or at the adult has a Quincke's edema, first aid has to be given the patient even before arrival of doctors. It is the most important to suspend contact with allergen in this case urgently: for example, to take out a sting of an insect, to cease to administer medicine. If hypostasis developed owing to a sting, on the struck place it is possible to put a cold compress. The person who had a hypostasis should give a lot of drink before arrival of doctors. In certain cases sorbents – for example, absorbent carbon will be also effective. If at the patient the difficulty of breath and discoloration of the person owing to development at it of a Quincke's edema takes place, treatment of this state is carried out by means of intramuscular administration of Prednisolonum.
Prevention of a Quincke's edema
As the measures directed to prevention of a Quincke's edema, to the people inclined to allergic reactions it is necessary to keep to very rigid diet constantly. Allergens should be excluded not only from a diet, but also from an environment of the person. During forced contact with the substances causing allergic reaction (for example when plants blossom), it is necessary to accept antihistaminic drugs.
Special attention to preventive measures should be paid to parents whose children suffer from similar allergic reactions. For the prevention of sudden manifestations of a Quincke's edema it is necessary not only to prevent contact of the child with allergens, but also to care for purity in the house, to often carry out wet cleaning, to air the room, to watch the level of humidity and temperature.
Children who have high sensitivity to stings of insects need to avoid circulation without footwear on the street and carrying bright things which can attract insects. Besides, parents have to take care of a complete set of the first-aid kit in which there have to be always means for first aid to the child at sudden development of an allergy.
Section: Allergology